Occurrence of Trushna as an Upadrava in Patients Undergoing Chemotherapy for Breast Cancer: An Observational Study

Abstract

Background: Breast cancer is the most frequently diagnosed cancer among women worldwide. Chemotherapy remains one of the main treatment modalities but is associated with numerous adverse effects that reduce patients' quality of life. Ayurveda describes Trushna as an important Upadrava (complication) associated with various disease conditions. Exploring chemotherapy-induced toxicities through Ayurvedic principles may facilitate integrative supportive care.

Objective: To evaluate the occurrence of Trushna as an Upadrava among breast cancer patients undergoing chemotherapy and to correlate chemotherapy-induced toxicities with Ayurvedic symptomatology.

Materials and Methods: An analytical cross-sectional observational study was conducted among 50 breast cancer patients receiving first-line neoadjuvant or adjuvant TEC chemotherapy (Docetaxel/Paclitaxel, Epirubicin, and Cyclophosphamide) between January and June 2025 at Dr. D. Y. Patil Hospital, Nerul, Navi Mumbai. Patients aged 25–70 years who had completed at least one chemotherapy cycle were included. Symptom assessment was performed using the Memorial Symptom Assessment Scale (MSAS). Data were collected on the 7^th and 21^st day following chemotherapy.

Results: The mean age of participants was 50 ± 8.28 years. Most participants were married (90%) and had children (84%). Haematological toxicity occurred in 37.7% of patients, whereas 94% experienced non-haematological toxicity. The most prevalent symptoms included numbness (98%), neutropenia/cachexia/early menopause (98%), appetite loss and altered taste (96%), cognitive dysfunction (96%), peripheral neuropathy (94%), chemotherapy-induced nausea and vomiting (94%), xerostomia (94%), stomatitis with dry mouth (92%), malaise (92%), diarrhoea (56%), throat pain with difficulty speaking (56%), delirium (46%), and syncope/altered consciousness (32%). These symptoms demonstrated close similarity with Ayurvedic descriptions of Trushna and its associated Upadravas.

Conclusion: Chemotherapy-induced adverse effects exhibit substantial overlap with the Ayurvedic concept of Trushna Upadrava. Understanding these manifestations from an Ayurvedic perspective may provide a scientific basis for developing integrative supportive interventions aimed at improving quality of life among breast cancer patients receiving chemotherapy.